Medical History, Medications, and Pancreatic Cancer Risk

描述(由申请人提供)： 胰腺癌的危险因素尚未得到很好的确定。这项初步研究的目的是在一项基于病历摘要和电子实验室和药房数据的病例对照研究中，调查病史、用药与胰腺癌的关系。 我们的具体目标是： 1.研究医疗条件与胰腺癌风险的关系，重点是： A.糖尿病，包括病程、治疗和血糖控制。 胰腺炎症，包括急性和慢性胰腺炎。 C.消化性溃疡病史和/或幽门螺杆菌感染(幽门螺杆菌)。 D.有胆囊癌和/或胆石症病史。 2.探讨非甾体抗炎药、降胆固醇药HMG-CoA还原酶抑制剂和组胺受体拮抗剂、质子泵抑制剂等酸抑制药物与胰腺癌的关系。 作为第二个特定目标，我们建议检查额外的医疗条件和药物，以便为未来胰腺癌流行病学和预防研究产生假设。这些包括对肠易激综合征、过敏和哮喘等医疗条件的评估，以及包括免疫抑制药物和血管紧张素转换酶抑制剂在内的药物的评估。 为了实现这些特定的目标，我们建议在大型健康维护组织团体健康合作社的限定人群中进行一项胰腺癌病例对照研究，包括250例新诊断病例和1000名对照。将通过提取传统和计算机化的医疗记录，包括电子实验室和药房数据，收集有关以前的医疗状况和药物的数据。研究的优势包括统一收集的长期医疗和药学数据的可用性，以及包括吸烟在内的重要协变量数据的可用性。这项拟议的研究将提供一个独特的机会，以调查医疗条件和药物在胰腺肿瘤发生中的作用，并对导致胰腺癌的机制产生新的见解。

DESCRIPTION (provided by applicant): Risk factors for pancreatic cancer are not well established. The goal of this pilot study is to investigate the relation between medical history, medication use and pancreatic cancer in a case-control study based on medical record abstraction and electronic laboratory and pharmacy data. Our specific aims are: 1. To investigate the relation between medical conditions and pancreatic cancer risk, focusing on: a. Diabetes mellitus, including disease duration, therapy, and glycemic control. b. Pancreatic inflammation, including acute and chronic pancreatitis. c. History of peptic ulcer disease and/or infection with Helicobacter pylori (H. pylori). d. History of cholecystectomy and/or cholelithiasis. 2. To investigate the relation between the use of medications and pancreatic cancer, focusing on nonsteroidal anti-inflammatory drugs, cholesterol lowering agents including HMG-CoA reductase inhibitors and acid suppressive medications including histamine receptor antagonists and proton pump inhibitors. As a secondary specific aim we propose to examine additional medical conditions and medications in order to generate hypotheses for future studies of the epidemiology and prevention of pancreatic cancer. These include evaluation of medical conditions such as irritable bowel syndrome, allergies and asthma as well as medications including immunosuppressive medications and angiotensin converting enzyme inhibitors. To meet these specific aims we propose to conduct a case-control study of pancreatic cancer comprised of 250 newly diagnosed cases and 1,000 controls in the defined population of Group Health Cooperative, a large health maintenance organization. Data on prior medical conditions and medications will be collected through abstraction of traditional and computerized medical records, including electronic laboratory and pharmacy data. Study strengths include the availability of uniformly collected, long-term medical and pharmacy data and the availability of data on important covariates, including smoking. The proposed study will provide a unique opportunity to investigate the role of medical conditions and medications in pancreatic tumorigenesis and to generate new insights into the mechanisms that result in pancreatic cancer.